Swiss Catalogue of Learning Objectives for Undergraduate Medical Training

Under a mandate of the Joint Commission of the Swiss Medical Schools

4. Problems as Starting Points for Training

for definition see Chapter 2

... general symptoms

Objective ID  
P 1   loss of bloodE
P 2   overweight / feeling too fat
P 3   loss of weight, emaciation
P 4   loss of appetite
P 5   malnutrition
P 6   fatigue
P 7   excessive daytime sleepiness (EDS)
P 8   general feeling of illness
P 9   enlarged lymph nodes (lymphadenopathy)
P 10   fever
P 11   fever in the immunocompromised host / recurrent fever
P 12   hypothermiaE
P 13   hyperthermiaE
P 14   abnormal perspiration
P 15   flushing
P 16   excessive thirst / excessive fluid intake (polydipsia)
P 17   dehydratationE
P 18   unexpected, sudden death of unknown etiology and non-natural deathE

... metabolic alterations and abnormal laboratory values

Objective ID  
P 19   hyperglycemia / diabetes mellitus
P 20   hypoglycemia
P 21   abnormal serum calcium / phosphate
P 22   abnormal pH of blood
P 23   abnormal serum lipids
P 24   abnormal liver function tests
P 25   abnormal serum potassium / magnesium
P 26   abnormal serum sodium
P 27   abnormalities of white blood cells
P 28   anemia
P 29   polycythemia / elevated hemoglobin
P 30   hypoxia, hypoxemia
P 31   hypercapnia / hypocapnia
P 32   proteinuria
P 33   renal failure

... skin manifestations

Objective ID  
P 34   paleness
P 35   cyanosis
P 36   jaundice (icterus), including neonatal jaundice
P 37   acute swelling and/or changing color of body partsE
P 38   skin inflammation
P 39   skin eruptions, skin rash
P 40   acne
P 41   boils
P 42   increased bleeding tendency (hemorrhagic diathesis)
P 43   itching
P 44   skin blisters
P 45   insect sting
P 46   wounds
P 47   burn / cold injuryE
P 48   electrical traumaE
P 49   skin ulcers
P 50   mole (nevus)
P 51   change of skin pigmentation
P 52   skin tumors
P 53   excess hair (hirsutism)
P 54   lack of hair (alopecia) , excess loss of hair
P 55   abnormalities of the nails

... head, face, neck

Objective ID  
P 56   headache, recurring / chronic
P 57   headache, sudden / newE
P 58   facial pain
P 59   lack of / diminished facial movement
P 60   lockjaw (trismus)
P 61   trauma to the head including cerebral traumaE
P 62   face injuries
P 63   toothache
P 64   neck pain
P 65   stiffness of neck
P 66   swelling in the neck
P 67   goiter

... ear, nose, mouth, tongue, throat, voice

Objective ID  
P 68   ear ache
P 69   discharge from ear
P 70   loss of hearing, slow / suddenE
P 71   ringing in the ears (tinnitus)
P 72   nose bleed (epistaxis)
P 73   nasal obstruction
P 74   nasal discharge
P 75   snoring
P 76   abnormalities of lips / tongue / mouth
P 77   increased secretion of saliva
P 78   dry mouth / dry throat
P 79   fetor oris (halitosis)
P 80   sore throat
P 81   problems with denture
P 82   alteration of voice (hoarseness / aphonia / dysphonia)

... eyes

Objective ID  
P 83   slow loss of vision
P 84   sudden partial / temporary loss of vision / loss of visual fieldE
P 85   squint (strabismus)
P 86   night-blindness
P 87   floating objects in the eye
P 88   light flashes (photopsia)
P 89   double vision (diplopia)
P 90   photophobia
P 91   acute eye pain / burning in the eyeE
P 92   foreign body / sandy feeling in the eye
P 93   itching eye
P 94   red eye
P 95   tearing eye
P 96   eye obscured by pus or mucus
P 97   blepharospasm
P 98   abnormal eye movements
P 99   abnormalities of pupils
P 100   exophthalmos (proptosis)
P 101   trauma to the eyeE
P 102   swollen eyes / swollen eyelids

... breast, chest, heart, blood pressure, pulse

Objective ID  
P 103   breast: sense of weight / pain / tension
P 104   breast: change in size / outline / symmetry
P 105   gynecomastia
P 106   breast lump
P 107   breast: retracted skin / nipple
P 108   breast: discharging nipple, including galactorrhea
P 109   breast: eczema of nipple / areola
P 110   swollen axilla
P 111   wheezing respiration
P 112   dyspneaE
P 113   apneaE
P 114   increased respiratory frequency
P 115   painful respiration
P 116   cough
P 117   hemoptysis
P 118   tightness of the chest, chest discomfort
P 119   chest painE
P 120   chest traumaE
P 121   pleural effusion
P 122   palpitations
P 123   irregular pulse / bradycardia / tachycardiaE
P 124   pulseless patientE
P 125   high blood pressure
P 126   low blood pressure
P 127   vascular injuries

... abdomen, stomach, bowels

Objective ID  
P 128   food intolerance
P 129   disorder of food passage, including dysphagia
P 130   regurgitation, belching of undigested food
P 131   swallowed foreign body
P 132   bloated abdomen / swollen sensation in abdomen
P 133   abdominal mass
P 134   abdominal traumaE
P 135   heartburn (pyrosis)
P 136   epigastric pain
P 137   nausea / vomiting
P 138   abdominal painE
P 139   flatulence
P 140   diarrhea
P 141   constipation
P 142   hematemesis / melenaE
P 143   altered color or consistency of feces / blood / mucus / pus in feces
P 144   alteration of defecation pattern
P 145   painful defecation
P 146   fecal incontinence (encopresis)
P 147   rectal blood loss
P 148   anal itching / anal pain

... pelvic symptoms, urogenital problems

Objective ID  
P 149   dysuria
P 150   disordered micturation
P 151   urinary incontinence (enuresis)
P 152   altered appearance of urine
P 153   loin painE
P 154   swelling in groin
P 155   scrotal painE
P 156   scrotal mass / swelling
P 157   urethral discharge
P 158   anomaly of male external genitalia
P 159   painful coitus (dyspareunia)
P 160   erectile / ejaculatory dysfunction
P 161   premenstrual syndrome
P 162   disorders of menstruation / of menstrual cycle
P 163   dysmenorrhea
P 164   pelvic pain
P 165   pelvic mass
P 166   uterine prolapse / pelvic relaxation
P 167   midcycle pain
P 168   vaginal bleeding: intermenstrual / postmenopausal / during pregnancy / post partumE
P 169   vaginal discharge
P 170   abnormal female external genitalia
P 171   premature menopause
P 172   complaints related to the menopause, including flushing
P 173   request for contraception
P 174   request for delaying menstruation
P 175   suspicion of pregnancy
P 176   request for genetic counseling
P 177   request for abortion
P 178   infertile couple
P 179   high risk pregnancy
P 180   poor / excessive weight gain in pregnancy
P 181   fever during pregnancy
P 182   hypertension during pregnancy
P 183   abdominal pain during pregnancy
P 184   edema during pregnancy
P 185   lack of fetal movement
P 186   loss of amniotic fluid
P 187   premature labor

... bones, joints, back, extremities

Objective ID  
P 188   acute pain in limbsE
P 189   typical fractures: radius / scaphoid / finger / humerus / clavicle / vertebra / ribs / femur / pelvis / ankle
P 190   laceration, open wound
P 191   traumatic amputation of limbE
P 192   wound with delayed healing or infection
P 193   contusion, soft tissue bruising
P 194   distortion of joint: ankle / hand
P 195   dislocation of joint: shoulder / finger
P 196   shoulder trauma
P 197   knee injury
P 198   trauma to the back including spinal cord traumaE
P 199   polytraumaE
P 200   swollen or painful joints
P 201   deformities of joints
P 202   morning stiffness
P 203   reduction of strength and/or joint motility
P 204   muscular pain (myalgia) / cramps
P 205   back pain
P 206   abnormal gait
P 207   abnormal posture
P 208   exercise-induced leg pain (claudication)
P 209   leg edema / generalized edema
P 210   leg ulcers
P 211   pain / burning / numbness in the feet

... newborn, child, adolescent

Objective ID  
P 212   irritable / crying infant
P 213   hypotonic / floppy infant
P 214   diaper rash
P 215   problems with breast feeding
P 216   failure to thrive in infancy and childhood
P 217   refusal to eat / drink in infancy and childhood
P 218   enuresis / encopresis in infancy and childhood
P 219   limp / pain in lower extremity in children
P 220   motor / mental retardation / developmental delay in infancy and childhood
P 221   abnormal growth: slowing / acceleration
P 222   sudden infant death
P 223   precocious puberty / delayed puberty
P 224   hyperactive child

... elderly persons, aging

Objective ID  
P 225   cognitive impairment in elderly person
P 226   elderly patient dependent in basic activities of daily living
P 227   falls in elderly person
P 228   failure to thrive and malnutrition in elderly person
P 229   hearing / vision impairment in elderly person
P 230   immobility, bedridden patient
P 231   mobility impairment in elderly person
P 232   pain in elderly person
P 233   polypharmacy in elderly person
P 234   sexual dysfunction in elderly person
P 235   sleep disorder in elderly person
P 236   social isolation in elderly person
P 237   urinary incontinence in elderly person

... disorders of consciousness, balance, orientation, gait, movement

Objective ID  
P 238   dizziness / vertigo: acute / chronicE
P 239   impairment / loss of consciousness, comaE
P 240   falls
P 241   twitch, convulsion, seizureE
P 242   acute paralysis, including hemiplegiaE
P 243   tingling (paresthesia)
P 244   change in sense of touch in the skin
P 245   abnormal involuntary movements: tremor / dyskinesia / tic disorders

... mental, behavioral and psychological problems

Objective ID  
P 246   disorder of speech / of language
P 247   acute change in behavior / personalityE
P 248   obsessive-compulsive symptoms
P 249   aggressive and violent behavior towards othersE
P 250   autoaggressive behavior / risk of suicideE
P 251   self-neglect
P 252   loss of initiative and interest
P 253   change in emotions and moods
P 254   nervousness / tension / anxiety / acute stress
P 255   agitation
P 256   confusion
P 257   forgetfulness, disorders of memory
P 258   disorder of attention and concentration
P 259   insomnia / sleep-wake cycle disturbances
P 260   abuse of alcohol
P 261   smoking, use of tobacco
P 262   abuse of medicines
P 263   illicit drug abuse and dependence
P 264   suspicion of poisoningE

... other reasons for medical consultation or problems in medical care

Objective ID  
P 265   infant and child immunization / periodic health examination for infants and children
P 266   request for check-up, health examination / for immunization
P 267   counseling / immunizations, before / after trip to foreign (tropical) country
P 268   pre-operative medical evaluation
P 269   request for medical certificate
P 270   psychological / physical / sexual abuse
P 271   fear of cancer / of heart disease / of HIV / of veneral disease / of other serious disease
P 272   terminal disease, the dying patient

... psychosocial and interpersonal problems

Objective ID  
P 273   loss / death / illness of someone close
P 274   problems at work / concerning work conditions
P 275   absenteeism, non-attendance (school / work)
P 276   financial problems of patient / unemployment
P 277   problems in relationship with parents / partner / child